Barrett’s esophagus (BE) is a serious complication of chronic gastroesophageal reflux disease (GERD). Over time, exposure to stomach acid from GERD damages the lining of your esophagus — the tube that allows food to pass from your throat to your stomach. This damage causes cell changes that increase your risk of developing esophageal cancer.
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What Is Barrett's Esophagus (BE)?
Barrett’s esophagus (BE) is a serious complication of chronic gastroesophageal reflux disease (GERD). Over time, exposure to stomach acid from GERD damages the lining of your esophagus — the tube that allows food to pass from your throat to your stomach. This damage causes cell changes that increase your risk of developing esophageal cancer.
What are the stages of Barrett’s esophagus?
Stages of Barrett’s esophagus depend on the degree of precancerous cell changes, and include:
- Non-dysplastic Barrett’s esophagus — Low-risk precancerous cell changes.
- Low-grade dysplasia — Intermediate-risk precancerous cell changes.
- High-grade dysplasia — High-risk precancerous cell changes that increase your cancer risk.
- Esophageal adenocarcinoma — Cell changes have progressed to cancer.
How serious is Barrett’s esophagus?
If left undiagnosed and untreated, Barrett’s esophagus can increase your risk of developing cancer. However, cell changes that cause esophageal cancer usually happen slowly, and most people with Barrett’s esophagus never develop cancer. With ongoing monitoring, most people with Barrett’s esophagus can live a normal life.
How common is Barrett’s esophagus?
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 5% to 15% of people with chronic GERD symptoms go on to develop Barrett’s esophagus. Barrett’s esophagus affects about 5% of adults in the U.S. and 1% of the population worldwide.
What causes Barrett’s esophagus?
Barrett's esophagus is caused by chronic GERD, which leads to precancerous cell changes due to prolonged exposure to stomach acid and digestive juice.
Barrett's esophagus risk factors
Having GERD is the biggest risk factor for Barrett’s esophagus. It is also more common in Caucasian men and people over age 50. Other risk factors include:
- Being overweight.
- Having a family history of Barrett’s esophagus or esophageal cancer.
- Smoking or using tobacco products.
Complications of Barrett's esophagus
Barrett’s esophagus increases your risk of developing esophageal cancer. Although most people with Barrett’s esophagus do not develop cancer, it is important to have routine checkups to look for precancerous cell changes (dysplasia).
How can I prevent Barrett's esophagus?
Getting treatment for GERD is the best way to prevent Barrett’s esophagus. You can also reduce your risk by quitting smoking and managing other risk factors that could lead to GERD.
What Are the Signs and Symptoms of Barrett's Esophagus?
Barrett’s esophagus doesn’t cause symptoms. However, you may notice symptoms of GERD, including:
- Chest pain.
- Chronic cough.
- Difficulty swallowing.
- Heartburn.
- Horse voice.
- Nausea.
- Regurgitation (stomach contents coming back up into your mouth).
- Throat pain.
When should I see a doctor about my GERD symptoms?
If you have symptoms of GERD that last a long time, are severe, or don’t respond to dietary changes or over-the-counter medications, you should talk to your doctor. Effective GERD treatment can reduce your risk of developing Barrett’s esophagus.
If you have already been diagnosed with Barrett’s esophagus, you should follow your doctor’s recommendations for follow-up care.
How Do You Diagnose Barretts Esophagus?
Your doctor may recommend getting tested for Barrett’s esophagus if you have frequent, long-term GERD symptoms and other risk factors for developing the condition.
What to expect during your visit
If your doctor suspects Barrett’s esophagus, they will:
- Ask about your symptoms.
- Perform a physical exam.
- Order other tests.
- Review your health history and medications.
Tests to diagnose Barrett’s esophagus
Tests to diagnose Barrett’s esophagus include:
- Upper gastrointestinal (GI) endoscopy and biopsy — Your doctor will use a lighted tube with a camera called an endoscope to look inside your esophagus. During the procedure, your doctor will take several tissue samples from the lining of your esophagus for analysis in a lab.
Barrett’s esophagus prognosis
People with Barrett’s esophagus can live a normal life. However, early diagnosis, treatment, and ongoing follow-up care are important to reduce your risk of developing esophageal cancer.
In some cases, Barrett’s esophagus can come back even after treatment, making long-term follow-up care an important part of your treatment plan.
What is the life expectancy for people with Barrett’s esophagus?
Most people with Barrett’s esophagus have a normal life expectancy. However, if esophageal cancer develops, it can be life-threatening.
Does Barrett’s esophagus heal?
Treating GERD can help heal damage to your esophagus. However, sometimes cell changes found in Barrett’s esophagus are permanent.
How Do You Treat Barrett's Esophagus?
The goals of Barrett’s esophagus treatment are to reduce your risk of developing cancer and prevent the condition from progressing. UPMC experts take a personalized approach to Barrett’s esophagus treatment, depending on the stage, your overall health, and other factors.
Lifestyle changes
If you are having symptoms of GERD, your doctor may recommend lifestyle changes to manage your condition, including:
- Avoiding spicy, fatty, or acidic foods that trigger heartburn.
- Avoiding tight clothing.
- Cutting back on alcohol or quitting drinking altogether.
- Elevating the head of your bed if you have symptoms at night.
- Losing weight.
- Not eating within three hours of bedtime.
- Quitting smoking.
Medication
Your doctor may recommend medications called proton pump inhibitors (PPIs) to manage GERD symptoms. These medications are available over-the-counter and by prescription. They work by reducing the amount of stomach acid you produce, preventing further damage and allowing your esophagus to heal.
Endoscopy for Barrett’s esophagus
Your doctor may treat Barrett’s esophagus during an endoscopy procedure using:
- Cryotherapy — A procedure that uses cold liquid nitrogen to remove abnormal cells.
- Endoscopic mucosal resection — A procedure that involves cutting out abnormal cells.
- Radiofrequency ablation — A procedure that uses heat to remove abnormal cells.
Esophagectomy for esophageal cancer
During an esophagectomy, your doctor will remove the damaged sections of your esophagus and reconnect your stomach with healthy sections of your esophagus.
Why Choose UPMC for Barrett’s Esophagus Care?
When you choose UPMC for Barrett’s esophagus care, you will receive:
- Access to board-certified specialists — Our gastrointestinal and thoracic surgery specialists are experienced in caring for people with GERD and Barrett’s esophagus.
- Expert diagnosis and personalized care — Our team will develop a customized treatment plan to reduce your cancer risk and improve your quality of life.
- A full range of treatment options — We use the latest nonsurgical, minimally invasive, and surgical techniques to provide comprehensive care.
